Primary prevention

There are no primary prevention measures for immunocompetent patients.

For young infants or patients with underlying immunosuppressive disorders, exposure to areas with a high inoculum of Histoplasma should be avoided to prevent disseminated disease.

For patients with HIV/AIDS, CD4 counts <150 cells/mm³, and living in areas with an incidence of Histoplasma >10 cases per 100 patient-years or at high risk of occupational exposure, primary prophylaxis with itraconazole is recommended, although there are limited data to justify this approach.[23][24][25]​ In patients receiving antiretroviral therapy, primary prophylaxis with itraconazole can safely be discontinued when the patient’s HIV viral load is undetectable and the CD4 count has been ≥150 cells/mm³ for 6 months.[25]

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